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Injections were performed using a Hamilton syringe fitted with a 30-gauge needle following pre-puncture of the sclera with a 30-gauge needle superiorly

In vitro and animal studies have found that lipoic acid exhibits immunomodulatory properties through mechanisms that stimulate the production of cyclic AMP (cAMP) (90, 91) a central regulator of innate immune functions and inhibits the migration of immune cells into the brain and spinal cord (92), possibly by decreasing endothelial expression of cell adhesion molecules, inhibiting expression of enzymes like matrix metalloproteinases (MMP), and/or reducing the permeability of the blood-brain barrier (87, 89, 93, 94)

The strength of the doses is increased gradually to help manage the common side effects that most people experience as their body gets accustomed to the medication

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